Valvular & structural heart diseaseCohort study
Tailoring Antiplatelet Therapy Duration After Patent Foramen Ovale (PFO) Closure
- multicenter retrospective registry
- Inverse probability of treatment weighting
Authors' conclusion
In patients with a RoPE score ≥7, early discontinuation of APT after effective PFO closure was associated with a lower incidence of NACE at long-term follow-up.
Study context
- Population
- Patients who underwent PFO device closure between 1999 and 2013 at 12 Italian centers, with successful PFO closure, no significant residual shunt, and no other indication for long-term antithrombotic therapymean age 47 ± 12 years, 55% women, followed for 14.0 ± 3.1 years
- Participants
- 940 patients
- Exposure
- Antiplatelet therapy (APT) discontinuation vs continuation after PFO closure
- Outcome
- NACE, a composite of ischemic events (ischemic stroke, transient ischemic attack, or systemic embolism) and major bleeding (Bleeding Academic Research Consortium ≥3)
- Follow-up
- 14.0 ± 3.1 years
Main finding
As reported in the abstract
Adjusted hazard ratio
0.71
95% CI 0.38–1.37
P = 0.31
By group
APT discontinuation group vs APT continuation group
aHR 0.71 (95% CI 0.38–1.37); P = 0.31
Observational data: associations, not effects.
Further findings
Ischemic events
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| NACE by RoPE score (subgroup) · RoPE score ≥7 | 0.32 (0.11–0.90) | P = 0.039 | |
| NACE by RoPE score (subgroup) · RoPE <7 | 1.07 (0.49–2.35) | P = 0.89 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
- Ischemic events: P = 0.66
- Net adverse clinical events (NACE) by Risk of Paradoxical Embolism (RoPE) score (subgroup): P for interaction = 0.089
Safety
Major bleeding · lower in the APT discontinuation group
- Major bleeding: P = 0.014
Original publication
Tailoring Antiplatelet Therapy Duration After PFO Closure. JACC Adv. Published 30 June 2026. doi:10.1016/j.jacadv.2026.102943
Summarised from the published abstract; every number is checked against it